I publish original articles here but also comment in mainstream media. This is what I do every morning: Read More …
This video by Vox and Ezra Klein explains why American health care is so expensive, and it does so simply and effectively. It mentions each of the top issues I write about here at Modern Health Talk, including the political influence of a medical cartel that profits from treating illness and injury with a fee-for-service business model.
The video gives me an opportunity to highlight the many issues contributing to our high costs, with a short description and reference articles for each.
- There’s No Easy Fix
- Market Forces Don’t Work in Health Care
- A Medical Cartel Influences Public Policy
- Direct to Consumer Advertising Influences Public Attitudes
- Incentives are Misaligned with Goals
- Health is Not a Policy Objective but a Political Weapon
- Inequality affects Health Wealth, Opportunity & Influence
- Single-Payer is Not Enough
- Public Health Programs are Effective
- Medical Schools teach Diagnosis & Treatment, not Prevention
- Disruptive Business Models Break From Fee-for-Service
- Tech Solutions Define the Future of Healthcare
- Aging Populations Stress Support Systems
- Important Documentaries
This really is about healthcare, believe me. It’s also about free speech, commerce, education, employment, and the open Internet, so read on.
FCC Chairman Ajit Pai wants to gut Net Neutrality consumer protections and kill open Internet competition as a result. That’s not surprising since he formerly worked as an attorney for Verizon Communications, but there are many issues that are not well understood, and not being discussed.
I am so bothered by this that I sent personal notes to the five FCC Commissioners, shared my Net Neutrality perspectives, and urge them NOT to gut Net Neutrality.
Would you go to a Robot MD?
Xiaoyi is a Chinese robot doctor that just made history as the first machine to pass a medical licensing exam. That feat signals a future that’s increasingly reliant on artificial intelligence (AI) and other technologies driven by Moore’s Law. Read More …
Wealth Inequality in America
Because Congress is debating tax reform, I’m republishing this article to again raise the issue of inequality.
Rising income and wealth inequality leads to political inequality, and that threatens our democracy. After a Washington Post article concluded that People have no idea what inequality actually looks like, revised and republished this article, which I’m again revising today. It features some disturbing videos that help us understand the corrupting influence of big money in politics and the direct relationships between:
- Special interest lobbying and policies resulting in a widening of income & wealth gaps,
- Between the widening wealth gaps and poverty,
- Between Poverty and obesity,
- Between obesity and diabetes and other chronic illness,
- Between chronic illness and rising healthcare costs, and
- Between rising healthcare costs and our economic problems.
America’s Family Physicians are promoting Health is Primary, a communications campaign that reflects the values of family medicine, puts patients at the center of their care, and aims to improve the health of all Americans, as well as costs. The Washington Post last week carried their sponsored article about A Health Care Solution We Can’t Afford to Ignore: PRIMARY CARE.
These physicians are apparently frustrated by Congress and partisan politics that is so toxic to our healthcare system, and our health. The United States is known to spend twice as much per capita as other advanced nations on healthcare, but with worse outcomes, so I’m happy to see this organization expand the debate beyond just how to PAY for care and who bears the burden. I’m glad to see their goal of actually improving wellness and care delivery, because even Benjamin Franklin knew that “An ounce of prevention is worth a pound of cure,” and that was two centuries ago. Read More …
Prepare for the Time Change
that comes after Halloween
The biannual shift between Standard Time and Daylight Savings Time is like a society-imposed jet lag that can throw off your body clock and disrupt your sleep patterns. In the Spring we set our clocks forward overnight and thus lose an hour of sleep, and in the Fall we have the opportunity to gain an hour of sleep.
It’s easy to ask, “Is Health Care a Right or a Privilege,” but to answer the question we must dig deep into our souls and understand the plight of others.
I like to think I’m a compassionate person, able to empathize with others born into the wrong family or environment, and even those who just didn’t get as many breaks in life that I did, but it’s not always easy.
I also think sometimes about what it must be like for those living a life of privilege. That’s why the video featured here had such an impact on me, and I hope on you too. It directly relates to our political debates over healthcare and other social issues too. Read More …
The Real Estate section of The Washington Post featured an article that caught my eye and formed the basis of my post today. Builders imagine homes of the future — but some of their dreams are available today, by Michele Lerner, describes concepts that homebuilders are considering to make future homes healthier, safer, more accessible & adaptable, and more comfortable to live in & easier to run.
Ever thought about having a dedicated room with an operable opening on the top to accommodate drone deliveries? Or using a 3-D printer to supply hinges for your cabinets? Or imagined your home’s windows adjusting to light and seasons the way your photochromic glasses do: darkening slightly in the summer to reduce heat buildup and fading to black at night for privacy without shades? … Most of the trends expected to affect house designs address consumer’s concerns about healthier living, affordability and adaptability to future lifestyles.
In this referenced article, CBS picks 10 smart home products to help you Age In Place. They represent the various types of product categories available, from voice activated home control to smart doorbells, thermostats, and medication reminders. They even include a smart refrigerator from Samsung that starts at about $3,500, but you can make your existing fridge smart for less than $40.
“Aging in place” is a hot topic these days — particularly among baby boomers who want to maintain their independence.
While flocking to smaller homes in warmer climates is still attractive for some seniors easing into their later years, more and more people are choosing to stay where they are. In fact, 85 percent of homeowners 55 and older aren’t planning to sell their homes in the next year, according to a 2017 survey from Realtor.com.
“Aging in place really is a concept based on where you’re living and your preference to staying, whatever you home of choice is,” said Laurie Orlov, tech industry veteran, eldercare advocate and founder of Aging in Place Technology Watch.
Not every home is set up to ease the transition into adults’ older years, when mobility can become a major issue. Declining hearing, sight and mental awareness can also affect how easy or safe it is to continue living independently in a person’s home of choice. But smart home technology brings a whole host of solutions to the table.
Scroll through the smart home products that CBS featured at https://www.cbsnews.com/media/10-smart-home-features-to-help-you-age-in-place/.
As I wrote in Moore’s Law and the Future of Healthcare,
“Futurists regularly consider alternative scenarios and look at factors that can steer the future in one direction or another. That way, clients can select a preferred version of the future and know what they might do to make that future happen.
It’s relatively easy to extrapolate past trends, assuming that nothing prevents those trends from continuing at the same rate, but will they? One can also look at what’s possible by tracking research lab activity and then estimating how long it will take to bring those new technologies to market.
But a potentially better approach is to start with a solid understanding of market NEEDS and what drives the development of solutions for them, or factors that inhibit solutions. Changes in politics and public policy, for example, can be a huge driver, with Obamacare as an example, or a huge inhibitor. That’s why I’m so interested in various healthcare reforms that accompany tech innovation.”
In the following video, see how future technologies could impact human longevity, Earth’s environment, and artificial intelligence. Read More …
I published this article back in 2012 but updated it now because Senators Bill Cassidy and Lindsey Graham just introduced a bill they aim to ram through Congress without a CBO score or public hearings. Senator Bernie Sanders also has an Obamacare replacement. It’s a form of Medicare-for-All, and it’s gaining wide support among Democrats and the public.
GOOD NEWS UPDATE: Republicans failed to get enough votes to pass the Cassidy/Graham bill.
As founding editor of Modern Health Talk, I think both sides need to step back from partisanship, look at the big picture, consider all stakeholders, look to other advanced nations for inspiration, and combine the best properties of each into a public-private hybrid healthcare model.
Is Health Care a Right? — Dr. Atul Gawande, a surgeon and public-health researcher, wrote an amazing article for The New Yorker that asks a question that’s been dividing Americans. His interviews offer important new insights that were missing in the Republican push to repeal and replace the ACA without a single public hearing. Not only do we need to understand what other nations do, but we also need to understand the different perspectives of our own citizens. This amazing must-read article is a good companion to my own article on Single-Payer. Read More …
How will IBM Watson affect the Future of Healthcare? Will it replace physician functions or just be another tool for them?
IBM made healthcare news when it directed its Watson supercomputer and artificial intelligence (AI) research to target a high-profile target: CANCER. But it seems that many in the medical industry lack the imagination needed to envision the potential that Watson offers. That’s why I’m writing today.
I was disappointed by a Business Insider article, Doctors say IBM Watson is nowhere close to being the revolution in cancer treatment it was pitched to them as. It appeared overly critical and caused me to respond this way: Read More …
According to this article at MedicalXpress.com…
Researchers at The Ohio State University Wexner Medical Center and Ohio State’s College of Engineering have developed a new technology, Tissue Nanotransfection (TNT), that can generate any cell type of interest for treatment within the patient’s own body. This technology may be used to repair injured tissue or restore function of aging tissue, including organs, blood vessels and nerve cells. Read More …
In 2010, the small town of Collegedale, Tennessee had the dubious distinction of having the highest prevalence of Type II Diabetes in the world. Without a single endocrinologist in the small town, those suffering from this preventable and treatable form of the disease were unable to gain access to the treatment they needed.
Dealing with this issue firsthand, a local employer who operates a donut manufacturing plant decided to dedicate a portion of his warehouse to be used as a health clinic. By hiring an endocrinologist from Chattanooga to travel to his warehouse a few days a week, his employees were finally able to receive the help they so desperately needed. Read More …
2016 research by The Hartford and The MIT AgeLab revealed their Top 10 Smart Home Technologies For Mature Homeowners (press release below).
They conducted joint research to better understand which smart home technologies may benefit homeowners over the age of 50 and get their perspectives on smart home technology. This research involved an extensive review of new smart home technologies by leading experts in housing, aging, and technology and an online survey of homeowners.
Top 10 Smart Home Technologies
Smart home technologies that may make life easier, help with home
maintenance, and enhance safety and security for homeowners 50+.
Fixing our broken healthcare system, reducing costs, and improving care all comes down to getting the objectives and health incentives right.
This post is based on a comment I made when Pritpal Tamber called for “Creating a parallel system to health care” in MedCity News back in 2014.
At least for consumers, Modern Health Talk (www.mHealthTalk.com) can already be called the “Institute for New Health Thinking,” with well over 100 articles on Legislative, Public Policy, and Health Reform topics written for consumers, and over 700 on modern health topics in general.
I personally think fixing our broken healthcare system all comes down to agreeing on objectives and getting the INCENTIVES right, as I wrote five years ago when proposing a hybrid, public/private model of health care. The goal then was to exploit the different incentives of (1) capitalism and private sector organizations that measure success in business terms such as profit, ROI, and payback period, contrasted with (2) the public sector, which measures success quite differently and over much longer time periods. Read More …
I begin with this widely shared Facebook post by Dr. Wallach that calls out unscrupulous doctors, and I follow with my perspective of the modern killing fields caused by public policy.
THE KILLING FIELDS…. Dr. Joel Wallach
“The United States had lost 56,000 military personnel in Vietnam over a ten-year period, for an average of 5,600 per year. Millions of people poured out into the streets to protest these lost lives. We had political anarchy for the last three years of the Vietnam war because of these deaths. And because of these deaths, God forgive us, we shot and killed American students at Kent State in Ohio, who were just exercising their First Amendment rights to free assembly and free speech. YET NO GROUP WAS OUT MARCHING IN THE STREETS WITH PLACARDS PROTESTING THE KILLINGS BY THE MEDICAL PROFESSION. Read More …
By Brian Holzer MD, MBA, President, Kindred Innovations
[This blog post, originally published on LinkedIn, is based on my personal view and does not in any way reflect the opinions of the current organization I work for].
Last week I came across the article titled, “Cuts threaten rural hospitals hanging on by their fingernails” which reported that 673 rural hospitals were at risk of closing. The data came from the Chartis Center for Rural Health, which also cited that states including California, Oklahoma, Louisiana, Alabama, and Georgia were most at risk with as many as 79% of their rural hospitals facing possible closure.
Reports like these that imply an impending doom of the healthcare system, as we know it are almost a daily event. And the sensationalism of healthcare by politicians and the media only adds further distractions to a system that is starving for patience and unbiased pragmatism. There is also no shortage of articles professing solutions that say nothing more than we need to 1) create a system that ensures that everyone has access to health insurance; and 2) make sure that we contain the huge cost increases.
The real problem we are facing as a society is that Healthcare is a Unicorn…Healthcare is not the same as other markets. There is a widespread lack of transparency about both the costs and the effectiveness of treatments, and many other details that a customer or end consumer might use to make purchasing and utilization decisions in healthcare. If life were as simple as it is often taught in business school classrooms, fixing Healthcare should be as easy as learning from other industries and adopting best practices. So, let’s [apply lessons from] two industries-airlines and auto insurance. Read More …
|EDITOR: These [reposted 2015] stats are from Alzheimers.net, an online community dedicated to education, advocacy and supporting those whose lives have been impacted by Alzheimer’s disease and other forms of dementia. Alzheimers.net was created by people touched by Alzheimer’s to give caregivers, those with Alzheimer’s a place to share our passion for change and a cure for the disease. I added a short section on the impact of sleep duration & quality and a related infographic.|
Alzheimer’s Statistics Worldwide
- Worldwide, nearly 44 million people have Alzheimer’s or a related dementia. (Alzheimer’s Disease International)
- Only 1-in-4 people with Alzheimer’s disease have been diagnosed. (Alzheimer’s Disease International)
- Alzheimer’s and dementia is most common in Western Europe (North America is close behind)
- Alzheimer’s is least prevalent in Sub-Saharan Africa. (Alzheimer’s Disease International)
- Alzheimer’s and other dementias are the top cause for disabilities in later life. (Alzheimer’s Disease International)
EDITOR: Why does the self-styled “pro-life” party want so badly to raise the death rate through more guns and less healthcare? Some think it’s because white nationalists (aka white supremacists) fear that immigrants and minorities are getting more opportunities than they are. Others think it’s about wealthy elites maintaining political control in the face of sweeping demographic changes. Either way, it’s disgusting and tearing our nation apart. In the referenced article below, Congressional Democrats describe recent administration executive actions ACA Sabotage, to create a healthcare crisis, but Political Genocide may be a more fitting term.
If any of that makes you angry, watch the video at the end to learn why signing up for healthcare during the enrollment period os a good way to piss off Trump.
OBAMACARE SABOTAGE CONTINUES
Since his first day in office, President Trump has created vast uncertainty in health insurance markets. Here are some examples:
His Administration has refused to commit to making cost-sharing reduction (CSR) payments and failed to commit to enforcing the individual mandate, putting the integrity of the risk pool and affordability of coverage in jeopardy. Trump’s obvious attempts to manufacture a crisis caused uncertainty in the marketplace and prompted insurers to sharply increase premiums for the upcoming plan year, or pull out altogether.
By another executive order in October, Trump will allow associations to offer group insurance plans with skimpy benefits and offer lower cost plans to members nationally across state lines. Trump’s order would allow association health plans to be exempted from core Obamacare requirements like coverage of essential health benefits. The ACA’s essential health benefits include hospital care, prescription drugs, maternity care, and mental health. The aim was to broaden the risk pool by preventing insurers from offering cheap plans tailored to young and healthy customers at the expense of older and sicker people. Experts worry this will damage ACA exchangers and result in overall higher costs.
Trump wants to make it easier for businesses to require employees to pay for their own insurance using reimbursements. He also wants to open more loopholes for people to buy insurance outside of ACA markets, attracting younger and healthier people away from current markets. Experts think this will destabilize Obamacare by leaving behind a smaller insurance pool of older and sicker people, resulting in fewer insurers and higher premiums.
Trump’s executive order finally terminates CSR subsidies paid to insurance companies to help people between 100% and 250% of the poverty level pay for the insurance and health care they get through ACA exchanges. Ironically, Trump’s constant threats to terminate CSR subsidies caused uncertainty in insurance markets that exacerbated two problems he blamed on Obamacare – namely, high premiums and the exit of insurers. This intentional sabotage will harm the 7.1 million people, or 58% of Obamacare enrollees, who qualified for subsidies this year.
Signing up for insurance under Obamacare will be a lot harder this year. Trump has shortened the annual open-enrollment period (Now Nov.1 to Dec.15) and announced plans to take HealthCare.gov offline for 12 hours at a time during peek enrollment times, “for maintenance.” He also cut ACA enrollment advertising by 90% and cut funding for Navigator groups who help people navigate the complex enrollment process and pick a plan under the ACA exchanges or Medicaid.
Trump and GOP attacks on Obamacare could come back to bite them politically, because although they have pleased their base, they also made health care more expensive and more unavailable for many Americans, many of whom are in the red states where Trump won.
It’s Not Just Me, or the mainstream press, Saying This
Analysis by the nonpartisan Congressional Budget Office has shown that every Republican House and Senate bill to replace Obamacare would (1) increase overall costs significantly and (2) cause tens of millions of people to get health insurance coverage. Sabotage can be even worse, and Congressional Democrats have weighed in on that issue.
Democratic members of the House Committee on Energy and Commerce and the Senate Committee on Health, Education, Labor, and Pensions recently released a report warning that Republican actions are causing uncertainty in health insurance markets that is resulting in higher premiums and insurers pulling out. A Manufactured Crisis: Trump Administration and Republican Sabotage of the Health Care System is summarized here with quotes from insurance companies and regulators across nearly 20 states. Read More …